Moving from triple feeding to breastfeeding

[hopingforapeainapod]

Hi all, DS is 2 weeks old and currently triple feeding (breastfeeding with expressed milk and formula top ups) due to losing 11% of his birth weight at day 5 and having a terrible latch. We have now diagnosed him with a bad lip tie and tongue tie which we are having lasered on Tuesday and after that I would really like to move back to breastfeeding with the occasional bottle of formula.

I am a bit worried about my supply keeping up with this though, and was wondering if anyone had any advice or experience of making this transition?

I have also noticed the number of mls he is drinking has really increased over the last couple of days, and unless I am tied to a pump all day (which is just not feasible for lots of reasons) I can’t really express enough for him, and so the number of mls in his top ups he is getting from formula rather than breast milk is increasing which is not really what I want, but this triple feeding schedule is gruelling enough as it is :(

Pump, pump and more pumping.

As much skin to skin and nipple time for him.

Breast massages, plenty of oats, hand pump too.

Sorry going to say almost the opposite of the other comment. I’ve been in your shoes, I absolutely tortured myself pumping and doing everything to improve my baby’s feeding (genuinely, everything). Honestly, I now look back and feel sad about how much of his newborn phase I wasted and the effect it had on my mental health. I now have a beautiful, clever 21 month old who realistically had mostly formula (100% formula from 4 months). Have to admit - I would NOT have followed this advice, I was a woman possessed!! But if you can, be kind to yourself and stop/ reduce just as soon as you want to. Boobs were still great for cuddles and comfort but without the horrible pressure. Emily Oster has a great article about the actual proven by data benefits of breast milk which may help you.

My advice was assuming she wants to get to fully BF. In which case, keeping supply up is key. However Tuesday isn't far away and once the physical issues are sorted, having baby feeding well is the best way to up supply.

@Rosiebob yeah it’s only been two weeks but I somewhat feel the same - I feel like so much time and energy has been consumed already worrying about feeding him and in many respects he may have just been happier and healthier had we just gone with formula feeding from the start, as breastfeeding has been so hard for him! I think what I am struggling with the most is I just hate pumping - I love the intimacy/bonding of breastfeeding but I hate being tied to a machine unable to do anything else except wait and watch the milk slowly come - especially when that time could be used for newborn cuddles instead! So even if we end up combi feeding breastmilk and formula I’m okay with that, it’s just the triple that I am really not enjoying!

@Hercisback1 I think once the tie division has been done I agree I will need lots of skin to skin and just practice latching as much as possible. I need to grin and bear it and try and get my supply up as much as possible before Tuesday, which I know isn’t far away but I’m just already struggling with a pumping schedule which I know should probably be increased…

Yeah I wanted to throw the pump out the window. Just thinking about the noise still makes me feel tense. Try covering it up so you can’t see how much there is and putting relaxing music on. You could see how Tuesday goes, do the exercises and reassess, we had 2 tongue tie procedures with no improvement. Just be good to yourself!

I wouldn't listen to anything Emily oster says!

Once the tongue and lip tie has been sorted. Baby feeding off the boob is better for your supply than pumping z

I'd say just feed as much as you can whenever he wants to get that supply up. Dedicate a few days to just feeding. I never tried pumping so cant help there. Lots of Lansinoh for the nipples!
Feeding issues happen with formula too so don't feel bad, we spent so long trying to get the right bottle/teat/milk for DC1 who used to projectile vomit half his feeds that we didn't know how much he was actually getting. It was a nightmare and the main reason I decided to try and breastfeed DC2 &3, it was a doddle compared to formula (for me) and very much more laid back about it all. Dc1 is 19 now! Basically the first few weeks/months can be tough for many reasons regardless of how you feed.

Why?

Not quite the same but I couldn't bf my second child until she was 11 days old as I was ill and she was fed through an ng tube.

Until then I pumped a lot including through the night.

When we did start to bf I pretty much just kept her by my boob for a few days so she could feed whenever and continued to pump a few times a day.

After a week we had bf established and I stopped pumping unless I needed some expressed milk for a bottle.

First of all: getting a tongue tie divided is (for most babies) not a magic bullet. It takes at least 2 weeks for the tongue to gain full function. Please continue to get specialist BF support for your latch as I've seen so many women who think that this is the answer but without work on positioning it just doesn't make much difference.
In my experience mothers will say the first feeds post division are amazing and different but then they experience a regression for a couple of days.

Milk is made on milk removal so the more you can feed your baby, the better, especially between 12-4am. Pump then if you can't BF.

Use a slow flow teat and paced bottle feed (look this up on youtube). Also try getting your milk flowing before baby goes to the breast so that they get instant gratification there but have to work for the bottle.

Remember they will take more formula because it's easier, and also it does not contain leptin, the hormone that tells them they are full.

I've triple fed two babies and it is absolutely horrendous so hats off to you, OP. One thing i would say is just to be realistic about improvements from the TT division. The benefits don't always come immediately - some babies do see immediate improvement, but when my DD2 had her 90% tie divided at 8w, we didn't see much improvement for another 6-8weeks. This was despite doing the massages and stretches as advised. In fact, we were referred to a paediatrician to check nothing else was going on. Unfortunately, I couldn't keep pumping for so long as I also have a toddler to look after plus i found the pump quite upsetting (i had to pump a lot for DD1 when she was in NICU) so i let my supply drift and moved to about 25% breastmilk (no pumping) and 75% formula. I don't want to be negative, but I wish someone had told me the benefits might not be immediate so I could mentally prepare myself.

I can't help re TT, but one of ours was in Neonatal intensive care and as I wanted to breastfeed, I pumped every 4 hours for the first 7 weeks while in hospital. I then continued on till 6 months - though not as often as every 4 hours and was allowed to breastfeed from 6 months. So they went from tube fed to bottle at 15 weeks to breast at 6 months. If you only have to persevere hopefully for a week / two weeks and keen to give it a go I would definitely say go for it as from 6 months life was so much easier and could feed on demand when out and about without the faff of bottles. Congratulations on your new arrival!

Oh and Lanisoh (?) is your saviour if it's your first. x

I made myself ill with stress from struggling to latch and pumping milk and bottle feeding. It was an added stress I didn't need on top of healing after a difficult labour and pregnancy. I felt like a failure when I moved to just formula feeding after a couple of weeks. My mood improved and I'm glad I stopped breast feeding. For some women, it comes naturally. But for other women, it isn't.

Second this. Lots of professionals assured me I could breeze into breastfeeding once issues were sorted. I couldn’t. Never could. Switched to formula at 2 months because combi/triple was causing so much stress.

Ditch the pump and bottles until dc is consistently gaining weight....

My experience is a sample size of 1!

Ds tongue tie cut at 4 weeks. Latch seemed to just work 2 weeks later, then back to square 1 for 24 hours, then it worked and has worked ever since.

I absolutely echo

1. what you're doing is so hard and not sustainable. I found it brutal but being able to breastfeed out and about was amazing, as was not having to Sterilise.
2. positioning and attachment still v important
3. hadn't done as much of the exercises as I thought I should have but DS was finger-fed rather than bottle fed until the latch worked, so think that acted as a workout for his sucking muscles until then.

I was too protective over BF and ended up with a bottle refuser. (I felt like I'd rather BF than pump the feed I was "missing", I was so worried it would slip through my fingers. But now I wish I'd just gone for at least a bottle of formula a day. It would also have meant that DP could do more settling, whereas I've ended up doing pretty much every bedtime.

You are already an amazing mum. Very best of luck with your journey.

Contact an IBCLC and make a plan to carefully reduce the top ups and pumping while monitoring weight and nappy output. I’ve been there, it’s exhausting, I hope you’re okay and getting some rest! X

We did this!

I started off BFing but DD got sick at 2 weeks (RSV) and struggled to latch so was tube fed. She fell off the centile chart, it was horrible.

I did pump, but my supply wasn't enough so topped up with formula.

She was on about 50/50 expressed milk and formula for a few weeks.

As she got stronger, I'd offer her the breast and she finally started to feed well at about 5 or 6 weeks old.

I hated pumping SO much so always tried to offer a breastfeed first, and if she didn't take a good one, I'd pump.

I did pump through the night (every 4 hours I think), as apparently it's important for supply.

I ended up getting a hands free pump (£50 or so from Amazon) as I hated having to be still and pump).

I'm so glad I stuck with the breastfeeding, as she's 10 months now and still going. Great for getting her to sleep and calming her down if upset :D

I remember being worried she'd refuse the breast as she found the bottle easy, but thankfully that wasn't an issue and she actually started to refuse the bottle at about 5 months old. Not ideal !

Just to say as well OP, I saw a lactation consultant (£200 or so for an in person visit the next day and ongoing support over the phone, plus another consult if I needed it) who helped with latch and positioning.
I had BF DS until 2.5 years and never needed to see one, but DD was a whole other kettle of fish! I found the consult quite helpful when DD wasn't latching well, and I could sometimes use the tips to get her to latch and have a full feed.

Also, I am not sure I would have persevered with the BFing if I didn't know from DS how easy it could be. No sterilising or taking bottles out. Able to co-sleep and BF through the night, so not getting out of bed to pump and make bottles. Honestly, once it clicks, BF is the easiest of all 3.

Dear all, thank you so much for your helpful replies. I’ve tried as hard as I can to continue with the pumping over the last couple of days and I do think I have noticed an increase in output and therefore hopefully supply. I am really hoping after Tuesday we will see some progress but appreciate the division may not be a magic bullet or we may not see radical improvements overnight so need to manage my expectations somewhat - I am just desperate to get out of this triple feeding / top ups cycle which has just been so consuming. I’m glad I’ve persevered as there’s been plenty of times this last week or so where I have wanted to throw in the towel but it’s just not sustainable long term! I have made my peace that if it doesn’t work I am fine with giving formula and can say I have tried everything - obviously I really really hope breastfeeding works out for all the reasons people have mentioned but if it doesn’t I’m trying not to put too much pressure on myself (easier said than done) and just want to enjoy my baby rather than obsessing about pumping and measuring mls!

@hopingforapeainapod hi, how did you get on in the end? I’m in a very similar position with my 2.5wk old. Triple feeding due to poor latch, poor suck and loss of weight during first week. We have tongue tie referral but waiting for appt news.

(Ps I think we spoke on a thread last year while TTC!)

Hi @Sierra26 thought I recognised your username! Congratulations! :) how did your ttc journey go in the end?

So long story short I continued to pump round the clock to increase my supply, and then we had his tongue tie lasered, but tbh it didn’t really help his latch, or at least not straightaway. I spoke to a lactation consultant who said it may take a few weeks for him to get the hang of it and that I would need to continue triple feeding until he did, but by this point I was so so sick of the triple feeding routine (it really is relentless) that I decided to give up breastfeeding - I also found not knowing how much he was having quite anxiety inducing after the weight drop - and so just gave 50% pumped milk and 50% formula (he always took bottles like a champ).

I did this until he was about 12 weeks and then my supply started to drop and I just couldn’t keep up so by 4 months I was probably only giving him 1 bottle of expressed milk a day and decided to stop.

Hopefully your tongue tie division will help with breastfeeding but my advice is don’t feel pressure to pump if you don’t want to. Looking back I really didn’t enjoy pumping but did it out of some strange sense of ‘duty’ and actually I regret it somewhat because it left me quite housebound in those first few months and took up a lottttt of time which could have been used doing nicer things (like cuddling my newborn!)